Wang Xin, Pan Jiadong
Department of Hand Microsurgery and Plastic Reconstructive Surgery, Ningbo No.6 Hospital, Ningbo Zhejiang, 315043, P. R. China.
Ningbo Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation, Ningbo Zhejiang, 315043, P. R. China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2025 Sep 15;39(9):1071-1075. doi: 10.7507/1002-1892.202508001.
To review the nomenclature, functional unit construction, technical essentials, and prevention and treatment of complications of functional perforator flaps, so as to provide references for the structural and functional reconstruction of composite tissue defects.
By retrieving and analyzing domestic and foreign literature on anatomical research, technical innovation and clinical application of functional design and application of perforator flaps, combined with the clinical practice of our team, the methods for harvesting and integrating functional units of perforator flaps were summarized.
Functional perforator flap refers to a perforator flap that, on the basis of perforator blood supply, carries one or more tissue functional units (such as muscles, nerves, lymphatic vessels, lymph nodes, bones, mucous membranes, joints or articular cartilages, .) with sufficient blood supply located in the supra-fascia and/or sub-fascia, and is used to reconstruct one or more functions of the recipient site. The design and transfer of functional perforator flaps should not only meet the needs of precise coverage of the wound, but also reconstruct the functions of the recipient site such as muscle contraction, flap sensation, lymphatic drainage, blood flow bridging, bone growth, glandular secretion or joint movement, while avoiding iatrogenic dysfunction in the donor site.
Functional perforator flaps have broken through the limitation of "wound coverage" and realize the integrated reconstruction of "structure-function-aesthetics".
回顾功能性穿支皮瓣的命名、功能单元构建、技术要点及并发症防治,为复合组织缺损的结构和功能重建提供参考。
通过检索和分析国内外关于穿支皮瓣功能设计与应用的解剖学研究、技术创新及临床应用的文献,并结合本团队临床实践,总结穿支皮瓣功能单元的切取与整合方法。
功能性穿支皮瓣是指在穿支供血基础上,携带位于深筋膜浅层和/或深层且血供充足的一个或多个组织功能单元(如肌肉、神经、淋巴管、淋巴结、骨骼、黏膜、关节或关节软骨等),用于重建受区一项或多项功能的穿支皮瓣。功能性穿支皮瓣的设计与转移不仅要满足创面精确覆盖的需求,还要重建受区如肌肉收缩、皮瓣感觉、淋巴引流、血流桥接、骨生长、腺体分泌或关节活动等功能,同时避免供区医源性功能障碍。
功能性穿支皮瓣突破了“创面覆盖”的局限,实现了“结构 - 功能 - 美学”的一体化重建。